Healthcare Provider Details
I. General information
NPI: 1336060813
Provider Name (Legal Business Name): RESILIENT MIND MENTAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2524 W FRONT ST
BERWICK PA
18603-4112
US
IV. Provider business mailing address
2524 W FRONT ST
BERWICK PA
18603-4112
US
V. Phone/Fax
- Phone: 859-312-1276
- Fax:
- Phone: 859-312-1276
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MICHAEL
LEFFLER
Title or Position: OWNER
Credential: LCSW
Phone: 570-849-0873